Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Value Health. 2009 Mar-Apr;12(2):392-6. doi: 10.1111/j.1524-4733.2008.00430.x. Epub 2008 Jul 24.
Few longitudinal studies have evaluated health-related quality of life (HRQoL) in Parkinson's disease (PD) and these studies have not evaluated all potentially relevant domains of PD. Our objective was to identify domains at baseline that predict change in HRQoL, and to evaluate the relation between change in HRQoL and change in particular domains of PD.
A total of 336 patients who participated in the longitudinal SCOPA-PROPARK cohort study and had data from the first and third annual evaluation were included in this study. The Scales for Outcomes in Parkinson's disease (SCOPA) evaluation was used to assess impairments and disabilities. HRQoL was assessed with the EuroQol-5D visual analogue scale. Multiple linear regression analysis with "change in HRQoL" as dependent variable was used to identify factors that influence the change in HRQoL.
Health-related quality of life as well as most impairment and disability domains decreased significantly from baseline to follow-up. The two regression models of "change in HRQoL," adjusted for baseline HRQoL, included 1) the baseline domains autonomic dysfunction, nighttime sleep problems, and cognitive function, and 2) "change in psychosocial problems,""change in depressive symptoms," and "change in cognitive function."
Patients who have autonomic dysfunction, nighttime sleep problems, and cognitive dysfunction are at risk for deterioration in HRQoL. Deterioration in HRQoL over 2-year time was associated with worsening in psychosocial well-being, mood, and cognitive function. Interventions aiming to improve these domains are important and would likely contribute to improvement in HRQoL, although more research is necessary.
少数关于帕金森病(PD)的纵向研究评估了与健康相关的生活质量(HRQoL),但这些研究并未评估 PD 的所有潜在相关领域。我们的目的是确定基线时可预测 HRQoL 变化的领域,并评估 HRQoL 变化与 PD 特定领域变化之间的关系。
共有 336 名参加 SCOPA-PROPARK 纵向队列研究且在第一年和第三年评估中有数据的患者被纳入本研究。使用 SCOPA(帕金森病评定量表)评估来评估损伤和残疾。使用 EuroQol-5D 视觉模拟量表评估 HRQoL。使用多元线性回归分析,将“HRQoL 的变化”作为因变量,以确定影响 HRQoL 变化的因素。
从基线到随访,HRQoL 以及大多数损伤和残疾领域显著下降。“HRQoL 的变化”的两个回归模型,调整了基线 HRQoL,包括 1)基线自主神经功能障碍、夜间睡眠问题和认知功能域,以及 2)“心理社会问题的变化”、“抑郁症状的变化”和“认知功能的变化”。
自主神经功能障碍、夜间睡眠问题和认知功能障碍的患者有发生 HRQoL 恶化的风险。2 年内 HRQoL 的恶化与心理社会健康、情绪和认知功能的恶化相关。旨在改善这些领域的干预措施很重要,可能有助于提高 HRQoL,但还需要更多的研究。